Implications of IDH mutations on immunotherapeutic strategies for malignant glioma

Neurosurg Focus. 2022 Feb;52(2):E6. doi: 10.3171/2021.11.FOCUS21604.

Abstract

Immunotherapy has emerged as a promising approach for treating aggressive solid tumors, even within the CNS. Mutation in the metabolic gene isocitrate dehydrogenase 1 (IDH1) represents not only a major glioma defining biomarker but also an attractive therapeutic neoantigen. As patients with IDH-mutant glioma enter early-phase vaccine and immune checkpoint inhibitor clinical trials, there is emerging evidence that implicates the oncometabolite, 2-hydroxyglutarate (2HG), generated by the neomorphic activity of mutant IDH, as a potential barrier to current immunotherapeutic approaches. Here, the authors review the immunomodulatory and immunosuppressive roles of 2HG within the unique IDH-mutant glioma tumor immune microenvironment and discuss promising immunotherapeutic approaches currently being investigated in preclinical models.

Keywords: 2-hydroxyglutarate; IDH; glioma; immunology; immunosuppression; isocitrate dehydrogenase; tumor immune microenvironment.

MeSH terms

  • Brain Neoplasms* / genetics
  • Brain Neoplasms* / metabolism
  • Brain Neoplasms* / therapy
  • Glioma* / genetics
  • Glioma* / therapy
  • Humans
  • Immunotherapy
  • Isocitrate Dehydrogenase / genetics
  • Mutation / genetics
  • Tumor Microenvironment

Substances

  • Isocitrate Dehydrogenase